Cleveland Orthodontics in Middlesbrough

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NHS Orthodontics

How do we decide whether you qualify for NHS orthodontic treatment?

NHS orthodontics for children

Are you eligible for NHS treatment?

All orthodontic practices in England offering NHS treatment have Contracts with NHS England. These Contracts provide the terms and conditions under which NHS treatment can be provided. All Contracts held by any practice have a section that refers to the Index of Orthodontic Need (IOTN).

Free NHS Consultation

Children and teenagers under 18 years of age are entitled to a free NHS consultation but we must receive a written referral from your dentist. At Cleveland Orthodontics, we are committed to seeing NHS referrals as soon as possible.


IOTN (Index of Orthodontic Treatment) is a scoring system that tells us a patient’s “need” for treatment. Some patients have a very high need for treatment. Examples might include patients whose teeth stick out a lot, or are very crooked. Providing orthodontic treatment will improve the health of the teeth.


Other patients have a low need for treatment. Examples include patients whose teeth are only slightly crooked. Providing treatment will not necessarily maker the teeth any healthier, although it might make them look a little nicer.

And of course, there are many patients who are somewhere in the middle of these two extremes.


The IOTN allows an orthodontist to give a score that indicates how great a patient’s need for treatment. The score consist of two numbers. The first refers to measurements that the orthodontist makes of the teeth which ranges from 1 to 5. The second refers to comparing your teeth to a set of photographs and ranges from 1 to 10. A high score indicates a high treatment need and therefore a large health benefit to the patient if treatment is provided. A low score indicates a low treatment need, with little or no health benefit if treatment is provided.

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Frequently asked questions

NHS treatment is available to patients with the following IOTN scores:
  • All patients whose first score is 4 or 5
  • All patients whose first score is 3, and the second score is 6 or above
This ensures that NHS treatment is provided to those patients who have the greatest need for treatment and will have clear health benefits as a result of that treatment.

Some patients have crooked teeth and would still like to have them straightened but unfortunately do not qualify for NHS treatment due to a low IOTN score (view our Silver Plan).

If you have a low score this may suggest that your teeth are not very crooked, and that having treatment will only provide minimal benefits. There is also a possibility that if retainers are not worn long term, your teeth could become crooked again, resulting in no benefit at all in the long run.

Your orthodontist will counsel you on whether pursuing treatment is appropriate, and of the risks and benefits involved.

Private consultation

Some families prefer their children to have an orthodontic consultation on a private basis. Please feel free to email us or telephone the practice on 01642 243080 for details on how private orthodontic cunsultations can be arranged.

Other orthodontic treatments

A comprehensive range of treatments for all orthodontic conditions


"The whole experience was great, the staff were very friendly and my appointments were always quick and on time - so I was able to fit them in around work. I now like showing off my smile and my self confidence has improved. My only regret is that I waited all those years before I plucked up the courage to do it!"


"After just 15 months I am amazed and very pleased with the smile I now have. I no longer hide from the camera and am more than happy to show off my brilliant smile and my self confidence in general is much higher. I only wish I had done it years ago."


"Now the brace is off after only 16 months – and I don’t know where the time has gone. For me the result is remarkable. It’s hard to believe how much movement can be achieved. Don’t think about it as long as I did. Make that appointment, you won’t regret it."


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